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This is VAERS ID 279213

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279213
VAERS Form:
Age:17.0
Gender:Female
Location:Oklahoma
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with a first 0.5 ml dose of Gardasil concomitantly with a dose of MENACTRA. The day after vaccination, the patient experienced low grade fever and aching. Un"specified medical attention was sought. Subsequently, the patient recovered. On an unspecified date the patient was vaccinated with a second dose of Gardasil by itself and there was no reaction. Additional information has been requested.


Changed on 12/8/2009

279213 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Oklahoma
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': (blank) WAES0704USA02554

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with a first 0.5 ml dose of Gardasil concomitantly with a dose of MENACTRA. The day after vaccination, the patient experienced low grade fever and aching. Un"specified Unspecified medical attention was sought. Subsequently, the patient recovered. On an unspecified date the patient was vaccinated with a second dose of Gardasil by itself and there was no reaction. Additional information has been requested.


Changed on 3/2/2010

279213 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Oklahoma
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unk Unknown
Allergies:
Diagnostic Lab Data: Unk Unknown
CDC 'Split Type': WAES0704USA02554

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with a first 0.5 ml dose of Gardasil concomitantly with a dose of MENACTRA. The day after vaccination, the patient experienced low grade fever and aching. Unspecified medical attention was sought. Subsequently, the patient recovered. On an unspecified date the patient was vaccinated with a second dose of Gardasil by itself and there was no reaction. Additional information has been requested. is not expected.


Changed on 4/7/2010

279213 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Oklahoma
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA02554

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with a first 0.5 ml dose of Gardasil concomitantly with a dose of MENACTRA. The day after vaccination, the patient experienced low grade fever and aching. Unspecified medical attention was sought. Subsequently, the patient recovered. On an unspecified date the patient was vaccinated with a second dose of Gardasil by itself and there was no reaction. Additional information is not expected.


Changed on 9/14/2017

279213 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Oklahoma
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA02554

Write-up:Information has been received from a physician concerning a 17 year old female who was vaccinated with a first 0.5 ml dose of Gardasil concomitantly with a dose of MENACTRA. The day after vaccination, the patient experienced low grade fever and aching. Unspecified medical attention was sought. Subsequently, the patient recovered. On an unspecified date the patient was vaccinated with a second dose of Gardasil by itself and there was no reaction. Additional information is not expected.


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